Individual provider Active NPI

Anissa Nicole Keyes, MA, LMFT, LICSW

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1154686590
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2538 Issued in MN
Practice address
1437 Marshall Ave # 204
Saint Paul, MN 55104-6350
Phone
(612) 284-8115
Fax
(763) 273-8892
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2538 MN Primary
Clinical Social Worker 1041C0700X 23288 MN

Addresses

Primary practice location

1437 Marshall Ave # 204
Saint Paul, MN 55104-6350

Mailing address

705 42ND Ave N FL 3
Minneapolis, MN 55412-1711
Phone (612) 284-8115

Other practice location 1

5201 Bryant Ave N
Minneapolis, MN 55430-3588
Phone (612) 284-8115

Other practice location 2

1437 Marshall Ave # 204
Saint Paul, MN 55104-6350
Phone (612) 284-8115

Other names 1

  • Anissa Keyes Beasley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201019003288 MN Practitioner - Clinical Social Worker 4880014596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Arubah Emotional Health Services, PAGroup PAC ID 3971923681, 5 clinicians

Practice addresses (Care Compare)

1437 Marshall Ave
Suite 204
Saint Paul, MN 55104-6350
Phone (763) 447-5573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2538MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arubah Emotional Health Services PA Marriage & Family Therapist CurrentSince Sep 26, 2020 Accepting new patients

Locations

705 42nd Ave N
Fl 3
Minneapolis, MN 55412
Phone (612) 284-8115

3300 County Road 10
Ste 204B
Minneapolis, MN 55429
Phone (612) 284-8115

5201 Bryant Ave N
Minneapolis, MN 55430
Phone (612) 284-8115

1437 Marshall Ave
#204
Saint Paul, MN 55104
Phone (612) 284-8115

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1154686590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 42ND AVE N FL 3",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121711",
            "telephone_number": "612-284-8115",
            "fax_number": "763-273-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 MARSHALL AVE # 204",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046350",
            "telephone_number": "612-284-8115",
            "fax_number": "763-273-8892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Bryant Ave N",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554303588",
            "country_code": "US",
            "telephone_number": "612-284-8115",
            "fax_number": "763-273-8892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1437 Marshall Ave # 204",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551046350",
            "country_code": "US",
            "telephone_number": "612-284-8115",
            "fax_number": "763-273-8892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEYES",
        "first_name": "ANISSA",
        "middle_name": "NICOLE",
        "credential": "MA, LMFT, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2538",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANISSA",
            "last_name": "BEASLEY",
            "middle_name": "KEYES",
            "credential": "MA, LMFT, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.